{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T15:15:54Z","timestamp":1773155754849,"version":"3.50.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1995,11]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            Increasingly over the past several years, patients have returned after coronary surgery for reoperative procedures, and the experience has become substantial. In this report, we describe immediate- and long-term outcomes after reoperative coronary artery bypass graft surgery.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            The source of data was the clinical database at Emory University. The surgical procedure and statistical methods were standard. Data were collected prospectively and entered into a computerized database. Follow-up was by letter, telephone, or hospital records documenting additional events resulting in readmission. In-hospital correlates of survival were determined by logistic regression, and long-term correlates were determined by Cox model analysis. There were 2030 patients with a mean age of 61 and a mean of 7.8\u00b14.1 years since the first surgery. The mean ejection fraction was close to 50%, and the majority had three-vessel or left main disease. Urgent or emergency surgery was required in 16.6%. The internal mammary was used in 60.1%. Q-wave myocardial infarctions occurred in just over 5%. Neurological events increased from 1.2% at less than age 50 to 4.1% at more than age 70. The hospital mortality increased from 5.7% at less than age 50 to 10% at more than age 70, with an overall rate of 7.0%. Mortality was 5.7% for elective, 10.9% for urgent, and 16.4% for emergency cases. Angina was noted at follow-up in 41.3%. Urgent or emergency surgery, reduced ejection fraction, hypertension, older age, and female sex were univariate and multivariate correlates of in-hospital death. Diabetes was a univariate correlate only. Five- and 10-year survival rates were 76% and 55%, respectively. Five- and 10-year myocardial infarction\u2013free survival rates were 63% and 40%, respectively. By 12 years, few patients were free of cardiac events. The univariate and multivariate correlates of long-term mortality were older age, reduced ejection fraction, hypertension, diseased vessels, presence of diabetes, congestive failure, and emergency surgery, with a strong trend for female sex. The use of the internal mammary artery was not a correlate for long-term mortality.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            Patients undergoing reoperative procedures have higher mortality initially and at long term than patients undergoing a first procedure. Expected mortality based on covariates may help in the decision of whether to perform reoperative coronary artery bypass graft surgery.\n          <\/jats:p>","DOI":"10.1161\/01.cir.92.9.50","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:34:42Z","timestamp":1339461282000},"page":"50-57","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":76,"title":["In-Hospital and Long-term Outcome After Reoperative Coronary Artery Bypass Graft Surgery"],"prefix":"10.1161","volume":"92","author":[{"given":"William S.","family":"Weintraub","sequence":"first","affiliation":[{"name":"From the Divisions of Cardiology and Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellis L.","family":"Jones","sequence":"additional","affiliation":[{"name":"From the Divisions of Cardiology and Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph M.","family":"Craver","sequence":"additional","affiliation":[{"name":"From the Divisions of Cardiology and Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"Grosswald","sequence":"additional","affiliation":[{"name":"From the Divisions of Cardiology and Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Guyton","sequence":"additional","affiliation":[{"name":"From the Divisions of Cardiology and Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, Ga."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)65229-0"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(94)90198-8"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36799-6"},{"key":"e_1_3_1_4_2","unstructured":"Christakis GT Ivanov J Weisel RD Birnbaum PL David TE Salerno TA and the Cardiovascular Surgeons of the University of Toronto. 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